Most people find it awkward when first talking with a friend or acquaintance who has just been diagnosed with cancer. Even though nearly everyone is well-intentioned, many say things that hurt or mystify more than they comfort.

Based on my own experiences and my conversations with others with cancer, here are some suggestions:

What to say

“How are you doing with all of this?” A simple question like this lets the person with cancer take the lead and opens the door for conversation.

“Would you like to grab a cup of coffee and talk?”

“I’m sorry.”

One friend describes two layers of response whenever she tells someone that she has cancer. The first layer is immediate, honest and from the gut. “Oh no. I’m so sorry.” The second layer is when the person begins saying those things they think they should say. “You’ll be fine. You’ll be playing tennis in a month.” She wishes that people would stop talking after the “I’m so sorry.”

What not to say

“Don’t worry. You’ll be fine.” Everyone’s natural instinct is to reassure the newly diagnosed that everything will be OK. But if you say to them “don’t worry,” they usually hear, “I’m afraid to talk about your cancer.”

You have to see this doctor or have this treatment or begin this cancer-fighting diet. People with cancer get way too much advice. If they want your advice, they’ll ask for it.

“That’s too bad about your cancer, but I could be hit by a bus tomorrow.” No one in the history of civilization has ever found comfort in these words, but people say it all the time.

“Do you smoke?” People with lung cancer get asked this routinely.

“Tell me how I can help.” This comment often comes from the heart, but it puts the burden on the person with cancer to think of and assign tasks. It’s better just to do things. Bring meals, take care of the kids for an evening, walk the dog, write cards of support, or call and say, “I’m heading to the supermarket. What can I pick up for you?”

As with other difficult conversations, the specific words are less important than the tangible presence of friends and loved ones. It’s OK if the words get a bit tangled. Those of us with cancer will recognize your intent and your kindness.